Questions to Ask a Midwife: Interview Checklist

Start with the basics: is she a Certified Nurse-Midwife (CNM), Certified Midwife (CM), or Certified Professional Midwife (CPM)? CNMs and CMs have graduate degrees and can work in hospitals. CPMs train specifically for out-of-hospital birth.

Ask what year she graduated, where she trained, and whether she holds current certification with AMCB or NARM. Certification requires continuing education and peer review, while a license just means the state allows her to practice.

Find out if she carries malpractice insurance. Some states don't require it for midwives, and some insurers won't offer it for home birth, but you want to know if you have recourse if something goes wrong.

Ask for total births attended and how many as the primary midwife. Someone who has attended 200 births as a student or assistant has different experience than someone who has managed 200 births herself.

Request her transfer rate, C-section rate, and postpartum hemorrhage rate for the last year or two. Per MANA Stats US data and Birthplace England UK data, intrapartum transfer rates run roughly 22.9-45% for first-time mothers and 7.5-12% for those who have given birth before. Her numbers should be in that broad range or she should be able to explain why her cohort differs.

Ask if she has ever had a maternal death or infant death, and if so, what happened. This is uncomfortable but necessary. How she answers tells you whether she takes responsibility and learns from bad outcomes.

She should name a specific hospital within 20-30 minutes of your home. Ask if she has admitting privileges or a collaborative agreement with a physician there. If not, you'll be handed off to whoever is on call, and she may not be allowed to stay with you.

Find out what percentage of her transfers are urgent versus non-urgent. Most transfers happen for slow labor or exhaustion, not emergencies, but you want to know she can recognize the difference.

Ask what happens to her fee if you transfer. Some midwives refund a portion, others don't. Know this before you sign a contract.

Midwifery fees typically run $3,000-$6,500 depending on your region. That usually covers all prenatal visits, the birth, and postpartum visits for six weeks. But you need to ask specifically.

Some midwives charge extra for home visits, lab work, birth tub rental, or a birth assistant. Others include a birth kit with supplies, while some expect you to buy your own. Get an itemized list of what's included and what you'll pay separately.

Ask about the payment schedule. Most midwives want payment in full by 36 weeks, which means you pay before the birth happens. If you transfer or have the baby in a hospital, find out if any portion is refundable.

Your midwife should carry oxygen for both you and the baby, IV fluids and the training to place an IV, medications to stop hemorrhage (like Pitocin and Cytotec), and newborn resuscitation equipment. Ask to see her birth bag or get a list of what's in it.

Find out if she has a doppler or fetoscope for monitoring the baby's heart rate, how often she'll check it during labor, and what heart rate patterns would make her recommend transfer. Intermittent monitoring is standard for low-risk home birth, but you want to know her specific protocol.

Ask about her training in neonatal resuscitation. She should have current NRP (Neonatal Resuscitation Program) certification. If the baby doesn't breathe right away, those first few minutes matter.

Most midwives bring an assistant or second midwife to the birth. Ask about this person's training and role. Will they help with monitoring and exams, or just set up supplies and take photos?

Find out if your midwife works in a practice with partners or if she's solo. Solo midwives often have a backup midwife who covers when they're sick, on vacation, or at another birth. You should meet this person before your due date.

Ask how many clients she takes per month. If she books more than 4-5 due dates in a four-week period, there's a real chance she'll miss your birth because she's at someone else's. Some practices have a policy that if your midwife can't make it, you get a partial refund.

This is where you find out if her approach matches yours. Some midwives are hands-off and won't suggest position changes or techniques unless you ask. Others are more directive. Neither is wrong, but you should know what you're getting.

Ask what she recommends for pain relief at home. Water, position changes, and counterpressure are standard, but some midwives offer sterile water injections or bring nitrous oxide. If you want these options, ask if she provides them.

Find out how she handles long labors and whether she has a time limit for pushing. Some midwives will support a 30-hour labor at home if mother and baby are stable. Others start talking about transfer after 18-24 hours. Know her limits before you're in labor.

Standard midwifery care includes at least three postpartum visits: one within 24-48 hours, one at two weeks, and one at six weeks. Ask if these happen at your home or in her office, and whether they're included in the base fee.

Find out what she checks at these visits. She should examine your bleeding, uterus, perineum, and any tears or stitches. For the baby, she should check weight, feeding, jaundice, and the umbilical cord. Some midwives do the newborn screening heel prick, others refer you to a pediatrician.

Ask if she's available by phone or text between visits, and what her typical response time is. Most midwives will answer questions about bleeding, breastfeeding, or baby concerns within a few hours, but clarify this upfront.

Looking for a midwife in your state? Each state article covers licensing, costs by region, Medicaid coverage, transfer hospitals, and what to ask before hiring. Start with: California, Texas, New York, Florida, Pennsylvania, Oregon, Washington, Colorado, Michigan, Georgia, Massachusetts, North Carolina, Utah, Vermont, Ohio , or browse all 50 states.